My research plan focuses on gastrointestinal cancer screening, surveillance and quality of care. The integrated research approach targets three clinical areas: colorectal cancer, ulcerative colitis and Barrett's esophagus. The study methods include observational research, measurement of patient centered outcomes, and decision modeling to answer important clinical questions regarding gastrointestinal cancer screening, surveillance and quality of care. Research projects focus on the quality of colorectal cancer care, assessment of diagnostic delay for cancer, validation and development of colorectal cancer screening measurement tools and data tracking systems, the measurement of health literacy as it relates to colorectal cancer screening and testing novel interventions to improve screening rates and decrease colonoscopy cancellations. Projects related to ulcerative colitis assess patient preferences for alternative therapies, the results of which will be incorporated into a decision model to provide a clinical decision making tool that can b e used in practice. We will assess perceived cancer risk in patients with Barrett's esophagus as a first step in developing an educational intervention to inform Barrett's patients about their cancer risk. The other critical component of my career plan is the structured mentoring program for gastroenterology/health services research fellows and medical residents. The program integrates coursework leading to a Master of Science degree with a mentoring program that provides the trainee with the opportunity for patient centered research experience. There is a gradual increase in his/her research independence under my supervision, leading to the design and execution of his/her own research project, including data analysis, abstract and manuscript preparation and presentation of the study results at a national meeting